How Failure Demand Keeps Us Stuck with John Mortimer

When Options Evolve: The End of Life Care Conversations We're Not Having

Canada has expanded the legal options available at the end of life — but the conversations with patients and families haven't kept up. In this episode, Kyla talks with Dr. Janine Brown, nurse researcher and PhD at the University of Saskatchewan, and Nabila Ashraf, public health researcher and Master's student in Aging Studies at the University of Regina. Together, they've been studying the social and political conditions that shape how Canadians navigate end-of-life decisions — from MAID to palliative care to the systemic gaps that make these conversations harder than they need to be. We discuss  why good end-of-life care keeps hitting the same walls — and what it would take to change that. If you work in healthcare, policy, or simply believe Canadians deserve better conversations about dying, this one is for you. Resources MAID Overview (Health Canada) [https://www.canada.ca/en/health-canada/services/health-services-benefits/medical-assistance-dying.html] MAID Saskatchewan [https://www.saskhealthauthority.ca/your-health/conditions-illnesses-services-wellness/all-z/medical-assistance-dying/accessing-maid-saskatchewan] Care Conversations with  Dr. Janine Brown [https://www.careconversations.ca/] End of Life Conversations Research Paper [https://link.springer.com/article/10.1186/s12904-026-02091-3] Advanced Care Planning Kit [https://www.dyingwithdignity.ca/download-acp-today/?gad_source=1&gad_campaignid=9007526357&gbraid=0AAAAADoD0uNuCIy0Bu0LUbPFYAL6AQgLm&gclid=CjwKCAjw6MPRBhBTEiwAd-7Mr8F-uJvqqOVqnoWso_QONq8qEVdpzSvwZdoBir8sG9G8H4me_SAomBoCpSYQAvD_BwE] Yellow Sleeve Program [https://www.saskhealthauthority.ca/your-health/conditions-illnesses-services-wellness/advance-care-planning] End of Life Planning Guide and Checklist [https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:9cbde191-bd49-45d8-8931-225a5bd2ef59] Parliamentary Report on MAID and Mental Illness [https://www.cbc.ca/news/politics/committee-maid-mental-illness-expansion-recommendation-9.7237992]

Patient Health Homes: What They Are and Why You Deserve One

In this episode, Kyla sits down with Dr Ginger Ruddy, a family physician and consultant with the Saskatchewan Medical Association, to break down what a patient medical home actually is, why the traditional fee-for-service model is holding us back, and what the future of primary care could look like for every person in this province. From Swift Current's same-day access model to the barriers of union integration and funding gaps, this is a frank conversation about the shift that's already underway — and what it will take to get there for everyone. Also, tune in at the end for another Shift Shout Out where we highlight an innovation from a nurse practitioner in Toronto who is reducing falls in hospitals and long-term care facilities across Canada with her innovative technology.     Resources ·      Crowfoot Family Practice, Calgary [https://www.cvfp.com/]  ·      Advancing Patient Medical Home: Insights from Swift Current [https://www.saskhealthquality.ca/training-webinars/events/advancing-the-patient-medical-home-model-in-rural-saskatchewan-insights-from-a-pilot-project-in-swift-current/]  ·      Saskatchewan Medical Association (SMA) — [http://www.sma.sk.ca/]  ·      Innovation Fund [https://www.sma.sk.ca/innovation-fund/]  ·      HALO Article (October 2025) [https://www.canhealth.com/2025/10/01/nurses-insight-sparks-canadian-patient-safety-innovation-with-halo/] ·      UHN Inventor of the Year [https://www.canhealth.com/2025/10/01/nurses-insight-sparks-canadian-patient-safety-innovation-with-halo/] ·      HALO Website [https://www.halotelemonitoring.com/]

Beyond the Back of the Ambulance: How Paramedicine is Evolving to Fill Gaps in Care

In this episode, we sit down with Angela Sereda [https://www.linkedin.com/in/angela-sereda-a2ab26260?originalSubdomain=ca], a senior leader in Mobile Integrated Health (MIH) with Medavie West, to discuss the shift happening in paramedicine. Angela shares her 33-year journey from a high school athletic trainer to a leader in community-based paramedicine. We explore how paramedics are expanding their role from being a purely reactive 911 service to becoming a proactive, integrated part of the healthcare system—meeting people where they’re at with the services they need.   If you enjoy this episode, please subscribe, share with friends and/or leave a review.  You can also follow me on Facebook and LinkedIn by searching @shiftpodcastcanada for more stories about transforming healthcare in Canada  Resources & Links   Medavie Video [https://www.youtube.com/watch?v=TyCxHPuHp7s&t=23s] Promising Practice: Medavie Community Paramedicine [https://acrobat.adobe.com/id/urn:aaid:sc:VA6C2:d2f0b05e-20c8-44fd-ae25-d148ca25ea38] (Report from Health Excellence Canada) Medavie Integrated health [https://medaviewest.ca/about-us/mobile-integrated-health/] Medavie Integrated Care Facility Programs [https://medaviewest.ca/about-us/mobile-integrated-health/mobile-integrated-care-facility-programs/] Withdrawal Management [https://www.saskhealthauthority.ca/news-events/news/mobile-withdrawal-program-changing-lives?fbclid=IwZXh0bgNhZW0CMTAAYnJpZBExSk05Z3JreVNTMmxydjJjcnNydGMGYXBwX2lkEDIyMjAzOTE3ODgyMDA4OTIAAR4XOgMWkBzBxdjcFvlRkEkpRtiDvX5vq_1KIkXhE2dP7TDgbM-a-A1Ze-vPIg_aem_YWdncwCBuOk6BUDbkyCSYy9nJiPr&brid=YWdncwHifh0Gm8klgcXssExK2qOv] Hospital at Home (Vancouver) [https://www.vch.ca/en/service/hospital-home#what_to_expect]

An Unlikely Duo Working Together to Address Transportation Challenges for Older Adults

In this episode, we explore an unlikely but powerful partnership between Terry Kostyna [https://www.linkedin.com/in/terry-kostyna-176152124/], a "get-shit-done" (GSD) entrepreneur and small-town mayor, and  Dr. Jacob Al Hassan [https://medicine.usask.ca/profiles/che/jacob-alhassan.php], an academic researcher focused on health equity. Together, they discuss their work with the Health Quality Council’s "Thrive at Home" initiative [https://www.saskhealthquality.ca/thrive-at-home/], specifically focusing on how rural communities can innovate to provide sustainable transportation for seniors. From volunteer-run shuttles to specialized software, Terry and Jacob share how they are working to bridge the gap between research and action to ensure older adults can age in place with dignity.   Resources  * Health Quality Council's Thrive at Home Initiative [https://www.saskhealthquality.ca/thrive-at-home/] * A Call for a Transportation Strategy [https://www.moosejawtoday.com/provincial-news/ndp-to-bring-forward-transportation-strategy-to-fill-stc-void-11879506] * Prince George's Social Prescribing Initiative [https://www.princegeorgecitizen.com/local-news/social-prescribing-helps-seniors-in-prince-george-12066894] * Drive Happiness (Alberta) [https://drivehappiness.ca/] * Gravelbourg Cares Shuttle [https://www.sasktoday.ca/southwest/assiniboia-times/community-support-key-to-success-of-gravelbourg-cares-shuttle-11579037]

How Failure Demand Keeps Us Stuck with John Mortimer

In this episode, I sit down with John Mortimer [https://www.linkedin.com/in/john-mortimer-06117083/?originalSubdomain=uk], a specialist in systemic service design and founder of Impro [https://www.improconsult.co.uk/about-john.html], to tackle a concept that is silently draining the resources and morale of our health care system: Failure Demand. John explains that much of the "spinning" felt by practitioners today—the feeling of running faster while staying in the same place—is the result of a system designed to manage the consequences of its own failures rather than meeting the actual needs of the person. If you have ever felt that you or your organization is only as helpful as the rules allow, this conversation offers ideas for finding traction in the spin and eliminating the invisible drain of failure demand. Resources John’s Videos on YouTube [https://www.youtube.com/channel/UCUvH-haM6CfwGnqHJ8Zx5xg]   Buurtzorg Mode [https://www.buurtzorg.com/about-us/buurtzorgmodel/]l  Human Learning Systems [https://www.humanlearning.systems/overview/]